腹腔镜联合纤维胆道镜治疗胆囊结石合并胆总管结石  

Treatment of cholecystolithiasis complicated with choledocholithiasis by laparoscopy together with choledochoscopy

作　　者：王勇 阮翊 

机构地区：[1]中平能化医疗集团总医院普外一区,平顶山467000

出　　处：《中国实用医药》2012年第26期27-28,共2页China Practical Medicine

摘　　要：目的总结腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床经验。方法回顾我院2008年11月至2011年11月连续收治的诊断明确的胆囊结石合并胆总管结石患者,行腹腔镜胆总管探查的216例患者,除4例患者手术中转外,其余212例患者均完成腹腔镜下胆囊切除胆总管切开胆道镜取石术。其中153例患者行T管引流,59例患者行胆总管一期缝合。比较两组患者手术时间,术后并发症,术后住院时间。结果两组患者的手术时间和并发症发生率差异无统计学意义,而胆总管一期缝合组的术后住院时间短于T管引流组。结论腹腔镜联合纤维胆道镜治疗胆囊结石合并胆总管结石具有创伤小、恢复快、住院时间短等优点,而有选择的行胆总管一期缝合,优势更显著。Objective To summarize the experience of clinical Use of laparoscopy combined with cho- ledochoscopyin treatment of eholecystolithiasis complicated with eholedocholithiasis. Methods Review chole- cystolithiasis complicated with chol edocholithiasis of patients diagnosed clear in November 2008 to November 201 ltreated in our hos- pital. Laparoseopic bravery manager of the 216 patients exploration, and in 4 patients conversion to open operation was done. The rest of the 212 patients underwent laparoscopic eholeeystectomyto- gerber with choledoe- holithotomy. Primary closure of common bile duet was carried out in 59 patients while T- tube drainage was done in 153 patients. The clinical date such as operative time , complication rate and operative hospital stay were comparatively analyzed between 2 groups. Results The differences of operative time , com- plication rate between two groups were not statistically significant（ P 〉 0.05 ）. There were sign- ifieant difference in operative hospital stay between the two groups （ P 〈 0. 05 ）. The operative hospital stay in primary closure group is shorter than the T-tube group. Conclusion Use of laparoscopy combined with choledoehoscopyin treat- ment of eholecystolithiasis complicated with eholedocholithiasis has the advantages of minimal invasion, quick re- covery and short hospital stay. Primary closure of common bile duct in selected cases brought additional benefits to the minimal invasive technique.

关 键 词：腹腔镜术 胆总管探查术 胆道镜 一期缝合 

分 类 号：R657.4[医药卫生—外科学]